Abstract
ObjectiveThe pathogenesis of cardiac allograft vasculopathy after heart transplant remains controversial. Histologically, cardiac allograft vasculopathy is characterized by intimal hyperplasia of the coronary arteries induced by infiltrating cells. The origin of these infiltrating cells in cardiac allograft vasculopathy is unclear. Endothelial progenitor cells are reportedly involved in cardiac allograft vasculopathy; however, the role of CD14+ monocyte-derived progenitor cells in cardiac allograft vasculopathy pathogenesis remains unknown.MethodsMonocyte-derived progenitor cells were isolated from blood mononuclear cell fractions obtained from 25 patients with cardiac allograft vasculopathy and 25 patients without cardiac allograft vasculopathy.ResultsBoth patients with cardiac allograft vasculopathy and those without cardiac allograft vasculopathy had CD45+, CD34+, CD14+, CD141−, CD31− monocyte-derived progenitor cells that differentiated into mesenchymal lineages. Monocyte-derived progenitor cells formed significantly higher numbers of colonies in patients with cardiac allograft vasculopathy than in those without cardiac allograft vasculopathy; this correlated with posttransplant follow-up time. Importantly, monocyte-derived progenitor cells from patients with cardiac allograft vasculopathy expressed significantly more α smooth muscle actin and proliferated at a higher rate than did monocyte-derived progenitor cells of patients without cardiac allograft vasculopathy. In vitro experiments suggested a paracrine control mechanism in proliferation of monocyte-derived progenitor cells in cardiac allograft vasculopathy.ConclusionsThese results indicate that monocyte-derived progenitor cells are associated with cardiac allograft vasculopathy, have the ability to transdifferentiate into smooth muscle cells, and thus may contribute to intimal hyperplasia of coronary arteries in cardiac allograft vasculopathy. Targeting monocyte-derived progenitor cell recruitment could be beneficial in cardiac allograft vasculopathy treatment.
Highlights
Monocyte-derived progenitor cells were isolated from blood mononuclear cell fractions obtained from 25 patients with cardiac allograft vasculopathy and 25 patients without cardiac allograft vasculopathy
Both patients with cardiac allograft vasculopathy and those without cardiac allograft vasculopathy had CD45þ, CD34þ, CD14þ, CD141À, CD31À monocyte-derived progenitor cells that differentiated into mesenchymal lineages
Monocyte-derived progenitor cells formed significantly higher numbers of colonies in patients with cardiac allograft vasculopathy than in those without cardiac allograft vasculopathy; this correlated with posttransplant follow-up time
Summary
Monocyte-derived progenitor cells were isolated from blood mononuclear cell fractions obtained from 25 patients with cardiac allograft vasculopathy and 25 patients without cardiac allograft vasculopathy. This study was approved by the ethics committee of the Medical University of Vienna, and a total of 50 heart transplant recipients who either had CAV (n 1⁄4 25) or showed no evidence of CAV (n 1⁄4 25) and gave informed consent to be enrolled were included. Patients were matched for age, sex, cardiac risk factors, and therapy. Twenty healthy volunteers who were comparable with study patients with respect to age and sex served as control subjects. One half of the blood was immediately centrifuged to obtain serum, coded and snap frozen; the other half was processed for mononuclear cell isolation
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